1
|
Kitagawa M, Abiko K, Sheriff S, Maudsley AA, Li X, Sawamura D, Ahn S, Tha KK. Brain Temperature as an Indicator of Cognitive Function in Traumatic Brain Injury Patients. Metabolites 2023; 14:17. [PMID: 38248820 PMCID: PMC10818445 DOI: 10.3390/metabo14010017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/27/2023] [Accepted: 12/20/2023] [Indexed: 01/23/2024] Open
Abstract
Whether brain temperature noninvasively extracted by magnetic resonance imaging has a role in identifying brain changes in the later phases of mild to moderate traumatic brain injury (TBI) is not known. This prospective study aimed to evaluate if TBI patients in subacute and chronic phases had altered brain temperature measured by whole-brain magnetic resonance spectroscopic imaging (WB-MRSI) and if the measurable brain temperature had any relationship with cognitive function scores. WB-MRSI was performed on eight TBI patients and fifteen age- and sex-matched control subjects. Brain temperature (T) was extracted from the brain's major metabolites and compared between the two groups. The T of the patients was tested for correlation with cognitive function test scores. The results showed significantly lower brain temperature in the TBI patients (p < 0.05). Brain temperature derived from N-acetylaspartate (TNAA) strongly correlated with the 2 s paced auditory serial addition test (PASAT-2s) score (p < 0.05). The observation of lower brain temperature in TBI patients may be due to decreased metabolic activity resulting from glucose and oxygen depletion. The correlation of brain temperature with PASAT-2s may imply that noninvasive brain temperature may become a noninvasive index reflecting cognitive performance.
Collapse
Affiliation(s)
- Maho Kitagawa
- Laboratory for Biomarker Imaging Science, Graduate School of Biomedical Science and Engineering, Hokkaido University, N15 W7, Kita-ku, Sapporo 060-8638, Japan; (M.K.); (X.L.)
| | - Kagari Abiko
- Department of Rehabilitation, Hokkaido University Hospital, Sapporo 060-8648, Japan;
- Department of Rehabilitation, Sapporo Azabu Neurosurgical Hospital, Sapporo 065-0022, Japan
| | - Sulaiman Sheriff
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (S.S.); (A.A.M.)
| | - Andrew A. Maudsley
- Department of Radiology, University of Miami Miller School of Medicine, Miami, FL 33136, USA; (S.S.); (A.A.M.)
| | - Xinnan Li
- Laboratory for Biomarker Imaging Science, Graduate School of Biomedical Science and Engineering, Hokkaido University, N15 W7, Kita-ku, Sapporo 060-8638, Japan; (M.K.); (X.L.)
| | - Daisuke Sawamura
- Department of Rehabilitation Science, Hokkaido University Faculty of Health Sciences, Sapporo 060-0812, Japan;
| | - Sinyeob Ahn
- Siemens Healthineers, San Francisco, CA 94553, USA;
| | - Khin Khin Tha
- Laboratory for Biomarker Imaging Science, Graduate School of Biomedical Science and Engineering, Hokkaido University, N15 W7, Kita-ku, Sapporo 060-8638, Japan; (M.K.); (X.L.)
- Global Center for Biomedical Science and Engineering, Faculty of Medicine, Hokkaido University, N15 W7, Kita-ku, Sapporo 060-8638, Japan
| |
Collapse
|
2
|
Zou Y, Heyn C, Grigorian A, Tam F, Andreazza AC, Graham SJ, Maclntosh BJ, Goldstein BI. Measuring Brain Temperature in Youth Bipolar Disorder Using a Novel Magnetic Resonance Imaging Approach: A Proof-of-concept Study. Curr Neuropharmacol 2023; 21:1355-1366. [PMID: 36946483 PMCID: PMC10324328 DOI: 10.2174/1570159x21666230322090754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Revised: 01/26/2023] [Accepted: 01/27/2023] [Indexed: 03/23/2023] Open
Abstract
BACKGROUND There is evidence of alterations in mitochondrial energy metabolism and cerebral blood flow (CBF) in adults and youth with bipolar disorder (BD). Brain thermoregulation is based on the balance of heat-producing metabolism and heat-dissipating mechanisms, including CBF. OBJECTIVE To examine brain temperature, and its relation to CBF, in relation to BD and mood symptom severity in youth. METHODS This study included 25 youth participants (age 17.4 ± 1.7 years; 13 BD, 12 control group (CG)). Magnetic resonance spectroscopy data were acquired to obtain brain temperature in the left anterior cingulate cortex (ACC) and the left precuneus. Regional estimates of CBF were provided by arterial spin labeling imaging. Analyses used general linear regression models, covarying for age, sex, and psychiatric medications. RESULTS Brain temperature was significantly higher in BD compared to CG in the precuneus. A higher ratio of brain temperature to CBF was significantly associated with greater depression symptom severity in both the ACC and precuneus within BD. Analyses examining the relationship of brain temperature or CBF with depression severity score did not reveal any significant finding in the ACC or the precuneus. CONCLUSION The current study provides preliminary evidence of increased brain temperature in youth with BD, in whom reduced thermoregulatory capacity is putatively associated with depression symptom severity. Evaluation of brain temperature and CBF in conjunction may provide valuable insight beyond what can be gleaned by either metric alone. Larger prospective studies are warranted to further evaluate brain temperature and its association with CBF concerning BD.
Collapse
Affiliation(s)
- Yi Zou
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Chinthaka Heyn
- Department of Medical Imaging, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Canada
| | - Anahit Grigorian
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Fred Tam
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Canada
| | - Ana Cristina Andreazza
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, M5T 1R8, ON, Canada
| | - Simon J. Graham
- Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Canada
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Bradley J. Maclntosh
- Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
- Heart and Stroke Foundation, Canadian Partnership for Stroke Recovery, Sunnybrook Research Institute, Toronto, ON, Canada
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
| | - Benjamin I. Goldstein
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Centre for Youth Bipolar Disorder, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, M5T 1R8, ON, Canada
| |
Collapse
|
3
|
Diprose WK, Morgan CA, Wang MT, Diprose JP, Lin JC, Sheriff S, Campbell D, Barber PA. Active conductive head cooling of normal and infarcted brain: A magnetic resonance spectroscopy imaging study. J Cereb Blood Flow Metab 2022; 42:2058-2065. [PMID: 35707879 PMCID: PMC9580175 DOI: 10.1177/0271678x221107988] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Active conductive head cooling is a simple and non-invasive intervention that may slow infarct growth in ischemic stroke. We investigated the effect of active conductive head cooling on brain temperature using whole brain echo-planar spectroscopic imaging. A cooling cap (WElkins Temperature Regulation System, 2nd Gen) was used to administer cooling for 80 minutes to healthy volunteers and chronic stroke patients. Whole brain echo-planar spectroscopic imaging scans were obtained before and after cooling. Brain temperature was estimated using the Metabolite Imaging and Data Analysis System software package, which allows voxel-level temperature calculations using the chemical shift difference between metabolite (N-acetylaspartate, creatine, choline) and water resonances. Eleven participants (six healthy volunteers, five post-stroke) underwent 80 ± 5 minutes of cooling. The average temperature of the coolant was 1.3 ± 0.5°C below zero. Significant reductions in brain temperature (ΔT = -0.9 ± 0.7°C, P = 0.002), and to a lesser extent, rectal temperature (ΔT = -0.3 ± 0.1°C, P = 0.03) were observed. Exploratory analysis showed that the occipital lobes had the greatest reduction in temperature (ΔT = -1.5 ± 1.2°C, P = 0.002). Regions of infarction had similar temperature reductions to the contralateral normal brain. Future research could investigate the feasibility of head cooling as a potential neuroprotective strategy in patients being considered for acute stroke therapies.
Collapse
Affiliation(s)
- William K Diprose
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | - Catherine A Morgan
- Centre for Advanced MRI, The University of Auckland, Auckland, New Zealand.,School of Psychology and Centre for Brain Research, The University of Auckland, Auckland, New Zealand
| | - Michael Tm Wang
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| | | | - Joanne C Lin
- School of Pharmacy, Faculty of Medical and Health Sciences, The University of Auckland, New Zealand
| | - Sulaiman Sheriff
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Doug Campbell
- Department of Anaesthesia and Perioperative Medicine, Auckland City Hospital, Auckland, New Zealand
| | - P Alan Barber
- Department of Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand.,Department of Neurology, Auckland City Hospital, Auckland, New Zealand
| |
Collapse
|
4
|
Dong Z, Kantrowitz JT, Mann JJ. Improving the reproducibility of proton magnetic resonance spectroscopy brain thermometry: Theoretical and empirical approaches. NMR IN BIOMEDICINE 2022; 35:e4749. [PMID: 35475306 DOI: 10.1002/nbm.4749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/25/2022] [Accepted: 04/19/2022] [Indexed: 06/14/2023]
Abstract
In proton magnetic resonance spectroscopy (1 H MRS)-based thermometry of brain, averaging temperatures measured from more than one reference peak offers several advantages, including improving the reproducibility (i.e., precision) of the measurement. This paper proposes theoretically and empirically optimal weighting factors to improve the weighted average of temperatures measured from three references. We first proposed concepts of equivalent noise and equivalent signal-to-noise ratio in terms of frequency measurement and a concept of relative frequency that allows the combination of different peaks in a spectrum for improving the precision of frequency measurement. Based on these, we then derived a theoretically optimal weighting factor and proposed an empirical weighting factor, both involving equivalent noise levels, for a weighted average of temperatures measured from three references (i.e., the singlets of NAA, Cr, and Ch in the 1 H MR spectrum). We assessed these two weighting factors by comparing their errors in measurement of temperatures with the errors of temperatures measured from individual references; we also compared these two new weighting factors with two previously proposed weighting factors. These errors were defined as the standard deviations in repeated measurements or in Monte Carlo studies. Both the proposed theoretical and empirical weighting factors outperformed the two previously proposed weighting factors as well as the three individual references in all phantom and in vivo experiments. In phantom experiments with 4- or 10-Hz line broadening, the theoretical weighting factor outperformed the empirical one, but the latter was superior in all other repeated and Monte Carlo tests performed on phantom and in vivo data. The proposed weighting factors are superior to the two previously proposed weighting factors and can improve the reproducibility of temperature measurement using 1 H MRS-based thermometry.
Collapse
Affiliation(s)
- Zhengchao Dong
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
| | - Joshua T Kantrowitz
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
- Nathan Kline Institute, Orangeburg, New York, USA
| | - J John Mann
- Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, New York, USA
- New York State Psychiatric Institute, New York, New York, USA
- Department of Radiology, Columbia University, College of Physicians and Surgeons, New York, New York, USA
| |
Collapse
|
5
|
Verma V, Lange F, Bainbridge A, Harvey-Jones K, Robertson NJ, Tachtsidis I, Mitra S. Brain temperature monitoring in newborn infants: Current methodologies and prospects. Front Pediatr 2022; 10:1008539. [PMID: 36268041 PMCID: PMC9577084 DOI: 10.3389/fped.2022.1008539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2022] [Accepted: 09/15/2022] [Indexed: 02/02/2023] Open
Abstract
Brain tissue temperature is a dynamic balance between heat generation from metabolism, passive loss of energy to the environment, and thermoregulatory processes such as perfusion. Perinatal brain injuries, particularly neonatal encephalopathy, and seizures, have a significant impact on the metabolic and haemodynamic state of the developing brain, and thereby likely induce changes in brain temperature. In healthy newborn brains, brain temperature is higher than the core temperature. Magnetic resonance spectroscopy (MRS) has been used as a viable, non-invasive tool to measure temperature in the newborn brain with a reported accuracy of up to 0.2 degrees Celcius and a precision of 0.3 degrees Celcius. This measurement is based on the separation of chemical shifts between the temperature-sensitive water peaks and temperature-insensitive singlet metabolite peaks. MRS thermometry requires transport to an MRI scanner and a lengthy single-point measurement. Optical monitoring, using near infrared spectroscopy (NIRS), offers an alternative which overcomes this limitation in its ability to monitor newborn brain tissue temperature continuously at the cot side in real-time. Near infrared spectroscopy uses linear temperature-dependent changes in water absorption spectra in the near infrared range to estimate the tissue temperature. This review focuses on the currently available methodologies and their viability for accurate measurement, the potential benefits of monitoring newborn brain temperature in the neonatal intensive care unit, and the important challenges that still need to be addressed.
Collapse
Affiliation(s)
- Vinita Verma
- Institute for Women's Health, University College London, London, United Kingdom
| | - Frederic Lange
- Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Alan Bainbridge
- Medical Physics and Engineering, University College London Hospital, London, United Kingdom
| | - Kelly Harvey-Jones
- Institute for Women's Health, University College London, London, United Kingdom
| | - Nicola J Robertson
- Institute for Women's Health, University College London, London, United Kingdom
| | - Ilias Tachtsidis
- Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Subhabrata Mitra
- Institute for Women's Health, University College London, London, United Kingdom
| |
Collapse
|
6
|
Brain Temperature Measured by Magnetic Resonance Spectroscopy to Predict Clinical Outcome in Patients with Infarction. SENSORS 2021; 21:s21020490. [PMID: 33445603 PMCID: PMC7827727 DOI: 10.3390/s21020490] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/06/2021] [Accepted: 01/07/2021] [Indexed: 02/01/2023]
Abstract
Acute ischemic stroke is characterized by dynamic changes in metabolism and hemodynamics, which can affect brain temperature. We used proton magnetic resonance (MR) spectroscopy under everyday clinical settings to measure brain temperature in seven patients with internal carotid artery occlusion to explore the relationship between lesion temperature and clinical course. Regions of interest were selected in the infarct area and the corresponding contralateral region. Single-voxel MR spectroscopy was performed using the following parameters: 2000-ms repetition time, 144-ms echo time, and 128 excitations. Brain temperature was calculated from the chemical shift between water and N-acetyl aspartate, choline-containing compounds, or creatine phosphate. Within 48 h of onset, compared with the contralateral region temperature, brain temperature in the ischemic lesion was lower in five patients and higher in two patients. Severe brain swelling occurred subsequently in three of the five patients with lower lesion temperatures, but in neither of the two patients with higher lesion temperatures. The use of proton MR spectroscopy to measure brain temperature in patients with internal carotid artery occlusion may predict brain swelling and subsequent motor deficits, allowing for more effective early surgical intervention. Moreover, our methodology allows for MR spectroscopy to be used in everyday clinical settings.
Collapse
|
7
|
Sharma AA, Nenert R, Mueller C, Maudsley AA, Younger JW, Szaflarski JP. Repeatability and Reproducibility of in-vivo Brain Temperature Measurements. Front Hum Neurosci 2020; 14:598435. [PMID: 33424566 PMCID: PMC7785722 DOI: 10.3389/fnhum.2020.598435] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Accepted: 11/30/2020] [Indexed: 12/11/2022] Open
Abstract
Background: Magnetic resonance spectroscopic imaging (MRSI) is a neuroimaging technique that may be useful for non-invasive mapping of brain temperature (i.e., thermometry) over a large brain volume. To date, intra-subject reproducibility of MRSI-based brain temperature (MRSI-t) has not been investigated. The objective of this repeated measures MRSI-t study was to establish intra-subject reproducibility and repeatability of brain temperature, as well as typical brain temperature range. Methods: Healthy participants aged 23-46 years (N = 18; 7 females) were scanned at two time points ~12-weeks apart. Volumetric MRSI data were processed by reconstructing metabolite and water images using parametric spectral analysis. Brain temperature was derived using the frequency difference between water and creatine (TCRE) for 47 regions of interest (ROIs) delineated by the modified Automated Anatomical Labeling (AAL) atlas. Reproducibility was measured using the coefficient of variation for repeated measures (COVrep), and repeatability was determined using the standard error of measurement (SEM). For each region, the upper and lower bounds of Minimal Detectable Change (MDC) were established to characterize the typical range of TCRE values. Results: The mean global brain temperature over all subjects was 37.2°C with spatial variations across ROIs. There was a significant main effect for time [F (1, 1,591) = 37.0, p < 0.0001] and for brain region [F (46, 1,591) = 2.66, p < 0.0001]. The time*brain region interaction was not significant [F (46, 1,591) = 0.80, p = 0.83]. Participants' TCRE was stable for each ROI across both time points, with ROIs' COVrep ranging from 0.81 to 3.08% (mean COVrep = 1.92%); majority of ROIs had a COVrep <2.0%. Conclusions: Brain temperature measurements were highly consistent between both time points, indicating high reproducibility and repeatability of MRSI-t. MRSI-t may be a promising diagnostic, prognostic, and therapeutic tool for non-invasively monitoring brain temperature changes in health and disease. However, further studies of healthy participants with larger sample size(s) and numerous repeated acquisitions are imperative for establishing a reference range of typical brain TCRE, as well as the threshold above which TCRE is likely pathological.
Collapse
Affiliation(s)
- Ayushe A. Sharma
- Department of Psychology, University of Alabama at Birmingham (UAB), Birmingham, AL, United States
- Department of Neurobiology, University of Alabama at Birmingham (UAB), Birmingham, AL, United States
- University of Alabama at Birmingham Epilepsy Center (UABEC), Birmingham, AL, United States
| | - Rodolphe Nenert
- University of Alabama at Birmingham Epilepsy Center (UABEC), Birmingham, AL, United States
- Department of Neurology, University of Alabama at Birmingham (UAB), Birmingham, AL, United States
| | - Christina Mueller
- Department of Psychology, University of Alabama at Birmingham (UAB), Birmingham, AL, United States
| | - Andrew A. Maudsley
- Department of Radiology, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Jarred W. Younger
- Department of Psychology, University of Alabama at Birmingham (UAB), Birmingham, AL, United States
| | - Jerzy P. Szaflarski
- Department of Neurobiology, University of Alabama at Birmingham (UAB), Birmingham, AL, United States
- University of Alabama at Birmingham Epilepsy Center (UABEC), Birmingham, AL, United States
- Department of Neurology, University of Alabama at Birmingham (UAB), Birmingham, AL, United States
- Department of Neurosurgery, University of Alabama at Birmingham (UAB), Birmingham, AL, United States
| |
Collapse
|
8
|
Annink KV, Groenendaal F, Cohen D, van der Aa NE, Alderliesten T, Dudink J, Benders MJNL, Wijnen JP. Brain temperature of infants with neonatal encephalopathy following perinatal asphyxia calculated using magnetic resonance spectroscopy. Pediatr Res 2020; 88:279-284. [PMID: 31896129 DOI: 10.1038/s41390-019-0739-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 12/10/2019] [Accepted: 12/15/2019] [Indexed: 01/20/2023]
Abstract
BACKGROUND Little is known about brain temperature of neonates during MRI. Brain temperature can be estimated non-invasively with proton Magnetic Resonance Spectroscopy (1H-MRS), but the most accurate 1H-MRS method has not yet been determined. The primary aim was to estimate brain temperature using 1H-MRS in infants with neonatal encephalopathy (NE) following perinatal asphyxia. The secondary aim was to compare brain temperature during MRI with rectal temperatures before and after MRI. METHODS In this retrospective study, brain temperature in 36 (near-)term infants with NE was estimated using short (36 ms) and long (288 ms) echo time (TE) 1H-MRS. Brain temperature was calculated using two different formulas: formula of Wu et al. and a formula based on phantom calibration. The methods were compared. Rectal temperatures were collected <3 hours before and after MRI. RESULTS Brain temperatures calculated with the formula of Wu et al. and the calibrated formula were similar as well as brain temperatures derived from short and long TE 1H-MRS. Rectal temperature did not differ before and after MRI. CONCLUSIONS Brain temperature can be measured using 1H-MRS in daily clinical practice using the formula of Wu et al. with both short and long TE 1H-MRS. Brain temperature remained within physiological range during MRI.
Collapse
Affiliation(s)
- Kim V Annink
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Floris Groenendaal
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Daan Cohen
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Niek E van der Aa
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Thomas Alderliesten
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Jeroen Dudink
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Manon J N L Benders
- Department of Neonatology, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - Jannie P Wijnen
- Department of Radiology, University Medical Center Utrecht, University Utrecht, Utrecht, The Netherlands.
| |
Collapse
|
9
|
Dehkharghani S, Yaghi S, Bowen MT, Pisani L, Scher E, Haussen DC, Nogueira RG. Mild fever as a catalyst for consumption of the ischaemic penumbra despite endovascular reperfusion. Brain Commun 2020; 2:fcaa116. [PMID: 33033801 PMCID: PMC7532660 DOI: 10.1093/braincomms/fcaa116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 05/18/2020] [Accepted: 06/23/2020] [Indexed: 11/26/2022] Open
Abstract
Cerebrovascular ischaemia is potentiated by hyperthermia, and even mild temperature elevation has proved detrimental to ischaemic brain. Infarction progression following endovascular reperfusion relates to multiple patient-specific and procedural variables; however, the potential influence of mild systemic temperature fluctuations is not fully understood. This study aims to assess the relationship between systemic temperatures in the early aftermath of acute ischaemic stroke and the loss of at-risk penumbral tissues, hypothesizing consumption of the ischaemic penumbra as a function of systemic temperatures, irrespective of reperfusion status. A cross-sectional, retrospective evaluation of a single-institution, prospectively collected endovascular therapy registry was conducted. Patients with anterior circulation, large vessel occlusion acute ischaemic stroke who underwent initial CT perfusion, and in whom at least four-hourly systemic temperatures were recorded beginning from presentation and until the time of final imaging outcome were included. Initial CT perfusion core and penumbra volumes and final MRI infarction volumes were computed. Systemic temperature indices including temperature maxima were recorded, and pre-defined temperature thresholds varying between 37°C and 38°C were examined in unadjusted and adjusted regression models which included glucose, collateral status, reperfusion status, CT perfusion-to-reperfusion delay, general anaesthesia and antipyretic exposure. The primary outcome was the relative consumption of the penumbra, reflecting normalized growth of the at-risk tissue volume ≥10%. The final study population comprised 126 acute ischaemic stroke subjects (mean 63 ± 14.5 years, 63% women). The primary outcome of penumbra consumption ≥10% occurred in 51 (40.1%) subjects. No significant differences in baseline characteristics were present between groups, with the exception of presentation glucose (118 ± 26.6 without versus 143.1 ± 61.6 with penumbra consumption, P = 0.009). Significant differences in the likelihood of penumbra consumption relating to systemic temperature maxima were observed [37°C (interquartile range 36.5 − 37.5°C) without versus 37.5°C (interquartile range 36.8 − 38.2°C) with penumbra consumption, P = 0.001]. An increased likelihood of penumbra consumption was observed for temperature maxima in unadjusted (odds ratio 3.57, 95% confidence interval 1.65 − 7.75; P = 0.001) and adjusted (odds ratio 3.06, 95% confidence interval 1.33 − 7.06; P = 0.009) regression models. Significant differences in median penumbra consumption were present at a pre-defined temperature maxima threshold of 37.5°C [4.8 ml (interquartile range 0 − 11.5 ml) versus 21.1 ml (0 − 44.7 ml) for subjects not reaching or reaching the threshold, respectively, P = 0.007]. Mild fever may promote loss of the ischaemic penumbra irrespective of reperfusion, potentially influencing successful salvage of at-risk tissue volumes following acute ischaemic stroke.
Collapse
Affiliation(s)
- Seena Dehkharghani
- Department of Radiology, New York University Langone Health, New York, NY, USA
| | - Shadi Yaghi
- Department of Neurology, New York University Langone Health, New York, NY, USA
| | - Meredith T Bowen
- Department of Neurology, Johns Hopkins University, Baltimore, MD, USA
| | - Leonardo Pisani
- Department of Neurology, Emory University Hospital, Atlanta, GA, USA
| | - Erica Scher
- Department of Neurology, New York University Langone Health, New York, NY, USA
| | - Diogo C Haussen
- Department of Neurology, Emory University Hospital, Atlanta, GA, USA.,Department of Neurology, Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Atlanta, GA 30303, USA
| | - Raul G Nogueira
- Department of Neurology, Emory University Hospital, Atlanta, GA, USA.,Department of Neurology, Marcus Stroke and Neuroscience Center, Grady Memorial Hospital, Atlanta, GA 30303, USA
| |
Collapse
|
10
|
Zhang Y, Taub E, Mueller C, Younger J, Uswatte G, DeRamus TP, Knight DC. Reproducibility of whole-brain temperature mapping and metabolite quantification using proton magnetic resonance spectroscopy. NMR IN BIOMEDICINE 2020; 33:e4313. [PMID: 32348017 DOI: 10.1002/nbm.4313] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 06/11/2023]
Abstract
Assessing brain temperature can provide important information about disease processes (e.g., stroke, trauma) and therapeutic effects (e.g., cerebral hypothermia treatment). Whole-brain magnetic resonance spectroscopic imaging (WB-MRSI) is increasingly used to quantify brain metabolites across the entire brain. However, its feasibility and reliability for estimating brain temperature needs further validation. Therefore, the present study evaluates the reproducibility of WB-MRSI for temperature mapping as well as metabolite quantification across the whole brain in healthy volunteers. Ten healthy adults were scanned on three occasions 1 week apart. Brain temperature, along with four commonly assessed brain metabolites-total N-acetyl-aspartate (tNAA), total creatine (tCr), total choline (tCho) and myo-inositol (mI)-were measured from WB-MRSI data. Reproducibility was evaluated using the coefficient of variation (CV). The measured mean (range) of the intra-subject CVs was 0.9% (0.6%-1.6%) for brain temperature mapping, and 4.7% (2.5%-15.7%), 6.4% (2.4%-18.9%) and 14.2% (4.4%-52.6%) for tNAA, tCho and mI, respectively, with reference to tCr. Consistently larger variability was found when using H2 O as the reference for metabolite quantifications: 7.8% (3.3%-17.8%), 7.8% (3.1%-18.0%), 9.8% (3.7%-31.0%) and 17.0% (5.9%-54.0%) for tNAA, tCr, tCho and mI, respectively. Further, the larger the brain region (indicated by a greater number of voxels within that region), the better the reproducibility for both temperature and metabolite estimates. Our results demonstrate good reproducibility of whole-brain temperature and metabolite measurements using the WB-MRSI technique.
Collapse
Affiliation(s)
- Yue Zhang
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
- Department of Neurosurgery and Core for Advanced MRI, Baylor College of Medicine, Houston, Texas, US
| | - Edward Taub
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
| | - Christina Mueller
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
| | - Jarred Younger
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
| | - Gitendra Uswatte
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
- Department of Physical Therapy, University of Alabama at Birmingham, Alabama, US
| | - Thomas Patrick DeRamus
- TReNDs Center for Translational Research in Neuroimaging and Data Science, Georgia, US
- Department of Psychology, Georgia State University, Georgia, US
| | - David C Knight
- Department of Psychology, University of Alabama at Birmingham, Alabama, US
| |
Collapse
|
11
|
Wu TW, Wisnowski JL, Geisler RF, Reitman A, Ho E, Tamrazi B, Chapman R, Blüml S. An In Vivo Assessment of Regional Brain Temperature during Whole-Body Cooling for Neonatal Encephalopathy. J Pediatr 2020; 220:73-79.e3. [PMID: 32089332 PMCID: PMC7265905 DOI: 10.1016/j.jpeds.2020.01.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 12/05/2019] [Accepted: 01/10/2020] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To assess differences in regional brain temperatures during whole-body hypothermia and test the hypothesis that brain temperature profile is nonhomogenous in infants with hypoxic-ischemic encephalopathy. STUDY DESIGN Infants with hypoxic-ischemic encephalopathy were enrolled prospectively in this observational study. Magnetic resonance (MR) spectra of basal ganglia, thalamus, cortical gray matter, and white matter (WM) were acquired during therapeutic hypothermia. Regional brain tissue temperatures were calculated from the chemical shift difference between water signal and metabolites in the MR spectra after performing calibration measurements. Overall difference in regional temperature was analyzed by mixed-effects model; temperature among different patterns and severity of injury on MR imaging also was analyzed. Correlation between temperature and depth of brain structure was analyzed using repeated-measures correlation. RESULTS In total, 53 infants were enrolled (31 girls, mean gestational age: 38.6 ± 2 weeks; mean birth weight: 3243 ± 613 g). MR spectroscopy was acquired at mean age of 2.2 ± 0.6 days. A total of 201 MR spectra were included in the analysis. The thalamus, the deepest structure (36.4 ± 2.3 mm from skull surface), was lowest in temperature (33.2 ± 0.8°C, compared with basal ganglia: 33.5 ± 0.9°C; gray matter: 33.6 ± 0.7°C; WM: 33.8 ± 0.9°C, all P < .001). Temperatures in more superficial gray matter and WM regions (depth: 21.9 ± 2.4 and 21.5 ± 2.2 mm) were greater than the rectal temperatures (33.4 ± 0.4°C, P < .03). There was a negative correlation between temperature and depth of brain structure (rrm = -0.36, P < .001). CONCLUSIONS Whole-body hypothermia was effective in cooling deep brain structures, whereas superficial structures were warmer, with temperatures significantly greater than rectal temperatures.
Collapse
Affiliation(s)
- Tai-Wei Wu
- Fetal and Neonatal Institute, Division of Neonatology, Children's Hospital Los Angeles, Los Angeles, CA; Department of Pediatrics, Keck School of Medicine, University of Southern California, Los Angeles, CA.
| | - Jessica L. Wisnowski
- Department of Radiology, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA;,Rudi Schulte Research Institute, Santa Barbara, CA
| | - Robert F. Geisler
- Division of Neonatology, Children’s Hospital, Fetal and Neonatal Institute, Los Angeles
| | - Aaron Reitman
- Division of Neonatology, Children’s Hospital, Fetal and Neonatal Institute, Los Angeles
| | - Eugenia Ho
- Division of Neurology, Children’s Hospital Los Angeles, Los Angeles, CA
| | - Benita Tamrazi
- Department of Radiology, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Rachel Chapman
- Division of Neonatology, Children’s Hospital, Fetal and Neonatal Institute, Los Angeles;,Department of Pediatrics, Keck School of Medicine, University of Southern California
| | - Stefan Blüml
- Department of Radiology, Children’s Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA;,Rudi Schulte Research Institute, Santa Barbara, CA
| |
Collapse
|
12
|
Dehkharghani S, Qiu D. MR Thermometry in Cerebrovascular Disease: Physiologic Basis, Hemodynamic Dependence, and a New Frontier in Stroke Imaging. AJNR Am J Neuroradiol 2020; 41:555-565. [PMID: 32139425 DOI: 10.3174/ajnr.a6455] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 01/02/2020] [Indexed: 01/20/2023]
Abstract
The remarkable temperature sensitivity of the brain is widely recognized and has been studied for its role in the potentiation of ischemic and other neurologic injuries. Pyrexia frequently complicates large-vessel acute ischemic stroke and develops commonly in critically ill neurologic patients; the profound sensitivity of the brain even to minor intraischemic temperature changes, together with the discovery of brain-to-systemic as well as intracerebral temperature gradients, has thus compelled the exploration of cerebral thermoregulation and uncovered its immutable dependence on cerebral blood flow. A lack of pragmatic and noninvasive tools for spatially and temporally resolved brain thermometry has historically restricted empiric study of cerebral temperature homeostasis; however, MR thermometry (MRT) leveraging temperature-sensitive nuclear magnetic resonance phenomena is well-suited to bridging this long-standing gap. This review aims to introduce the reader to the following: 1) fundamental aspects of cerebral thermoregulation, 2) the physical basis of noninvasive MRT, and 3) the physiologic interdependence of cerebral temperature, perfusion, metabolism, and viability.
Collapse
Affiliation(s)
- S Dehkharghani
- From the Department of Radiology (S.D.), New York University Langone Health, New York, New York
| | - D Qiu
- Department of Radiology (D.Q.), Emory University Hospital, Atlanta, Georgia
| |
Collapse
|
13
|
Mintzopoulos D, Ratai EM, He J, Gonzalez RG, Kaufman MJ. Simian immunodeficiency virus transiently increases brain temperature in rhesus monkeys: detection with magnetic resonance spectroscopy thermometry. Magn Reson Med 2019; 81:2896-2904. [PMID: 30652349 DOI: 10.1002/mrm.27635] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/19/2018] [Accepted: 11/20/2018] [Indexed: 01/14/2023]
Abstract
PURPOSE To evaluate brain temperature effects of early simian immunodeficiency virus (SIV) infection in rhesus macaques using proton magnetic resonance spectroscopy (MRS) thermometry (MRSt) and to determine whether temperature correlates with brain choline or myo-inositol levels. METHODS Brain temperature was retrospectively determined in serial MRS scans that had been acquired at baseline and at 2 and 4 weeks post-SIV infection (wpi) in 16 monkeys by calculating the chemical shift difference between N-acetylaspartate (NAA) and water peaks in sequentially acquired water-suppressed and unsuppressed point-resolved spectroscopy (PRESS) spectra. Frontal and parietal cortex, basal ganglia, and white matter spectra were analyzed. RESULTS At 2 wpi, brain and rectal temperatures increased relative to baseline and normalized at 4 wpi. Brain temperatures correlated with choline levels in several brain areas, but not with myo-inositol levels. CONCLUSION These data indicate that SIV transiently increases brain temperature soon after infection and that temperature is correlated with transient changes in choline levels. Given that choline levels are associated with brain inflammation in SIV-infected monkeys, our findings suggest that the SIV-induced temperature increase reflects brain inflammation. We conclude that MRSt may be informative in human immunodeficiency virus models and may be useful for assessing effects of treatments that reduce inflammation. This study also illustrates that existing MRS data sets containing unsuppressed water spectra can be used to measure tissue temperature, an important physiological parameter.
Collapse
Affiliation(s)
- Dionyssios Mintzopoulos
- McLean Imaging Center, McLean Hospital, Belmont, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Eva-Maria Ratai
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Julian He
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Ramon Gilberto Gonzalez
- A. A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Charlestown, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| | - Marc J Kaufman
- McLean Imaging Center, McLean Hospital, Belmont, Massachusetts.,Harvard Medical School, Boston, Massachusetts
| |
Collapse
|
14
|
Verius M, Frank F, Gizewski E, Broessner G. Magnetic Resonance Spectroscopy Thermometry at 3 Tesla: Importance of Calibration Measurements. Ther Hypothermia Temp Manag 2018; 9:146-155. [PMID: 30457932 DOI: 10.1089/ther.2018.0027] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
To demonstrate the importance of calibration measurements in 3 Tesla proton magnetic resonance (MR) spectroscopy (1H-MRS) thermometry for human brain temperature estimation for routine clinical applications. In vitro proton MR spectroscopy to obtain calibration constants of the water-chemical shift was conducted at 3 Tesla with a temperature-controlled phantom, containing a pH-buffered aqueous solution of N-acetyl aspartate (NAA), creatine (Cr), methylene protons of Cr (Cr2), dimethyl silapentane sulfonic acid (DSS), and sodium formate (NaFor). Estimations of absolute human brain temperature were performed utilizing the correlation of temperature to the water-chemical shift for the resonances of NAA, Cr, and Cr2. Data for calibration of the metabolites' chemical shift differences and in vivo temperature estimations were acquired with single-voxel point-resolved spectroscopy (PRESS) sequences (repetition time/echo time = 2000/30 ms; voxel size 2 × 2 × 2 cm3). Spectroscopy data were quantified in the time-domain, and a Pearson correlation analysis was performed to estimate the correlation between the chemical shift of metabolites and measured temperatures. The correlation coefficients (r) of our calibration measurements were NAA 0.9975 (±0.0609), Cr -0.9979 (±0.0621), Cr2 - 0.9973 (±0.0577), DSS -0.9976 (±0.0615), and NaFor -0.8132 (±2.348). The mean calculated brain temperature was 37.78 ± 1.447°C, and the mean tympanic temperature was 36.83 ± 0.2456°C. Calculated temperatures derived from Cr and Cr2 provided significant (p = 0.0241 and p = 0.0210, respectively) correlations with measured temperatures (r = 0.4108 and r = -0.4194, respectively). Calibration measurements are vital for 1H-MRS thermometry. Small numeric differences in measured signal and data preprocessing without any calibration measurements reduce accuracy of temperature calculations, which indicates that calculated temperatures should be interpreted with caution. Application of this method for clinical purposes warrants further investigation and a more practical approach.
Collapse
Affiliation(s)
- Michael Verius
- 1 Medizinische Universität Innsbruck, Neuroimaging Research Core Facility, Innsbruck, Austria
| | - Florian Frank
- 2 Medizinische Universität Innsbruck, Universitätsklinik für Neurologie, Innsbruck, Austria
| | - Elke Gizewski
- 1 Medizinische Universität Innsbruck, Neuroimaging Research Core Facility, Innsbruck, Austria.,3 Medizinische Universität Innsbruck, Universitätsklinik für Neuroradiologie, Innsbruck, Austria
| | - Gregor Broessner
- 2 Medizinische Universität Innsbruck, Universitätsklinik für Neurologie, Innsbruck, Austria
| |
Collapse
|
15
|
Posporelis S, Coughlin JM, Marsman A, Pradhan S, Tanaka T, Wang H, Varvaris M, Ward R, Higgs C, Edwards JA, Ford CN, Kim PK, Lloyd AM, Edden RAE, Schretlen DJ, Cascella NG, Barker PB, Sawa A. Decoupling of Brain Temperature and Glutamate in Recent Onset of Schizophrenia: A 7T Proton Magnetic Resonance Spectroscopy Study. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:248-254. [PMID: 29486866 PMCID: PMC5836506 DOI: 10.1016/j.bpsc.2017.04.003] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/27/2016] [Revised: 03/23/2017] [Accepted: 04/10/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND Converging evidence suggests that cerebral metabolic and cellular homeostasis is altered in patients with recent onset of schizophrenia. As a possible marker of metabolic changes that might link to altered neurotransmission, we used proton magnetic resonance spectroscopy to estimate brain temperature, and we evaluated its relationship to a relevant metabolite, glutamate, within this study population. METHODS Using proton magnetic resonance spectroscopy at 7T, 20 patients with recent onset (≤24 months after first psychotic symptoms) of schizophrenia and 20 healthy control subjects were studied. We measured levels of N-acetylaspartate and glutamate and estimated brain temperature in a noninvasive manner. RESULTS Healthy control subjects showed a significant negative correlation between glutamate and brain temperature in the anterior cingulate cortex. In contrast, the physiological correlation between glutamate and brain temperature was lost in patients with recent onset of schizophrenia. CONCLUSIONS This study supports the hypothesized disrupted relationship between brain metabolism and neurotransmission in patients with recent onset of schizophrenia. The findings include mechanistic implications that are to be followed up in both preclinical and clinical studies.
Collapse
Affiliation(s)
- Sotirios Posporelis
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland; South London and Maudsley National Health Service Foundation Trust, London, United Kingdom
| | - Jennifer M Coughlin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland; Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Anouk Marsman
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Subechhya Pradhan
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Teppei Tanaka
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Hongxing Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Mark Varvaris
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Rebecca Ward
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Cecilia Higgs
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Jamie A Edwards
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Candice N Ford
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Pearl K Kim
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Ashley M Lloyd
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Richard A E Edden
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - David J Schretlen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Nicola G Cascella
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Peter B Barker
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institutions, Baltimore, Maryland
| | - Akira Sawa
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medical Institutions, Baltimore, Maryland.
| |
Collapse
|
16
|
Owji ZP, Gilbert G, Saint-Martin C, Wintermark P. Brain Temperature Is Increased During the First Days of Life in Asphyxiated Newborns: Developing Brain Injury Despite Hypothermia Treatment. AJNR Am J Neuroradiol 2017; 38:2180-2186. [PMID: 28860214 DOI: 10.3174/ajnr.a5350] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/12/2017] [Indexed: 01/30/2023]
Abstract
BACKGROUND AND PURPOSE Therapeutic hypothermia is the current treatment for neonates with hypoxic-ischemic encephalopathy. It is believed to work by decreasing the brain temperature and reducing the baseline metabolism and energy demand of the brain. This study aimed to noninvasively assess brain temperature during the first month of life in neonates with hypoxic-ischemic encephalopathy treated with hypothermia. MATERIALS AND METHODS Neonates with hypoxic-ischemic encephalopathy treated with hypothermia and healthy neonates were enrolled prospectively. MR imaging was used to identify the presence and extent of brain injury. MR imaging multivoxel spectroscopy was used to derive brain temperatures in the basal ganglia and white matter at different time points during the first month of life. Brain temperature measurements were compared between neonates with hypoxic-ischemic encephalopathy and healthy neonates. RESULTS Forty-three term neonates with hypoxic-ischemic encephalopathy treated with hypothermia had a total of 74 spectroscopy scans, and 3 healthy term neonates had a total of 9 spectroscopy scans during the first month of life. Brain temperatures were lower in neonates with hypoxic-ischemic encephalopathy during hypothermia, compared with the healthy neonates (respectively, on day 1 of life: basal ganglia, 38.81°C ± 2.08°C, and white matter, 39.11°C ± 1.99°C; and on days 2-3 of life: basal ganglia, 38.25°C ± 0.91°C, and white matter, 38.54°C ± 2.79°C). However, neonates with hypoxic-ischemic encephalopathy who developed brain injury had higher brain temperatures during hypothermia (respectively, on day 1 of life: basal ganglia, 35.55°C ± 1.31°C, and white matter, 37.35°C ± 2.55°C; and on days 2-3 of life: basal ganglia, 35.20°C ± 1.15°C, and white matter, 35.44°C ± 1.90°C) compared with neonates who did not develop brain injury (respectively, on day 1 of life: basal ganglia, 34.46°C ± 1.09°C, and white matter, 33.97°C ± 1.42°C; and on days 2-3 of life: basal ganglia, 33.90°C ± 1.34°C, and white matter, 33.07°C ± 1.71°C). Also, brain temperatures tended to remain slightly higher in the neonates who developed brain injury around day 10 of life and around 1 month of age. CONCLUSIONS Therapeutic hypothermia using current guidelines decreased the brain temperature of neonates with hypoxic-ischemic encephalopathy during the first days of life but did not prevent an early increase of brain temperature in neonates with hypoxic-ischemic encephalopathy who developed brain injury despite this treatment.
Collapse
Affiliation(s)
- Z P Owji
- From the Department of Pediatrics, Division of Newborn Medicine, Research Institute of the McGill University Health Centre (Z.P.O., P.W.)
| | - G Gilbert
- MR Clinical Science (G.G.), Philips Healthcare, Montreal, Quebec, Canada
| | - C Saint-Martin
- Department of Pediatric Radiology (C.S.-M.), Montreal Children's Hospital, McGill University, Montreal, Quebec, Canada
| | - P Wintermark
- From the Department of Pediatrics, Division of Newborn Medicine, Research Institute of the McGill University Health Centre (Z.P.O., P.W.)
| |
Collapse
|
17
|
Maudsley AA, Goryawala MZ, Sheriff S. Effects of tissue susceptibility on brain temperature mapping. Neuroimage 2016; 146:1093-1101. [PMID: 27693198 DOI: 10.1016/j.neuroimage.2016.09.062] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2016] [Revised: 09/15/2016] [Accepted: 09/26/2016] [Indexed: 02/07/2023] Open
Abstract
A method for mapping of temperature over a large volume of the brain using volumetric proton MR spectroscopic imaging has been implemented and applied to 150 normal subjects. Magnetic susceptibility-induced frequency shifts in gray- and white-matter regions were measured and included as a correction in the temperature mapping calculation. Additional sources of magnetic susceptibility variations of the individual metabolite resonance frequencies were also observed that reflect the cellular-level organization of the brain metabolites, with the most notable differences being attributed to changes of the N-Acetylaspartate resonance frequency that reflect the intra-axonal distribution and orientation of the white-matter tracts with respect to the applied magnetic field. These metabolite-specific susceptibility effects are also shown to change with age. Results indicate no change of apparent brain temperature with age from 18 to 84 years old, with a trend for increased brain temperature throughout the cerebrum in females relative for males on the order of 0.1°C; slightly increased temperatures in the left hemisphere relative to the right; and a lower temperature of 0.3°C in the cerebellum relative to that of cerebral white-matter. This study presents a novel acquisition method for noninvasive measurement of brain temperature that is of potential value for diagnostic purposes and treatment monitoring, while also demonstrating limitations of the measurement due to the confounding effects of tissue susceptibility variations.
Collapse
|
18
|
Hartmann J, Gellermann J, Brandt T, Schmidt M, Pyatykh S, Hesser J, Ott O, Fietkau R, Bert C. Optimization of Single Voxel MR Spectroscopy Sequence Parameters and Data Analysis Methods for Thermometry in Deep Hyperthermia Treatments. Technol Cancer Res Treat 2016; 16:470-481. [PMID: 27422012 DOI: 10.1177/1533034616656310] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE The difference in the resonance frequency of water and methylene moieties of lipids quantifies in magnetic resonance spectroscopy the absolute temperature using a predefined calibration curve. The purpose of this study was the investigation of peak evaluation methods and the magnetic resonance spectroscopy sequence (point-resolved spectroscopy) parameter optimization that enables thermometry during deep hyperthermia treatments. MATERIALS AND METHODS Different Lorentz peak-fitting methods and a peak finding method using singular value decomposition of a Hankel matrix were compared. Phantom measurements on organic substances (mayonnaise and pork) were performed inside the hyperthermia 1.5-T magnetic resonance imaging system for the parameter optimization study. Parameter settings such as voxel size, echo time, and flip angle were varied and investigated. RESULTS Usually all peak analyzing methods were applicable. Lorentz peak-fitting method in MATLAB proved to be the most stable regardless of the number of fitted peaks, yet the slowest method. The examinations yielded an optimal parameter combination of 8 cm3 voxel volume, 55 millisecond echo time, and a 90° excitation pulse flip angle. CONCLUSION The Lorentz peak-fitting method in MATLAB was the most reliable peak analyzing method. Measurements in homogeneous and heterogeneous phantoms resulted in optimized parameters for the magnetic resonance spectroscopy sequence for thermometry.
Collapse
Affiliation(s)
- J Hartmann
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - J Gellermann
- 2 Department of Radiation Oncology, University Hospital Tübingen, Tübingen, Germany.,3 Praxis/Zentrum für Strahlentherapie und Radioonkologie, Berlin, Germany
| | - T Brandt
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M Schmidt
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - S Pyatykh
- 4 Medical Faculty Mannheim, Experimental Radiation Oncology, Heidelberg University, Mannheim, Germany
| | - J Hesser
- 4 Medical Faculty Mannheim, Experimental Radiation Oncology, Heidelberg University, Mannheim, Germany
| | - O Ott
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - R Fietkau
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - C Bert
- 1 Department of Radiation Oncology, Universitätsklinikum Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| |
Collapse
|
19
|
Wagner MW, Stern SE, Oshmyansky A, Huisman TAGM, Poretti A. The Role of ADC-Based Thermometry in Measuring Brain Intraventricular Temperature in Children. J Neuroimaging 2015; 26:315-23. [PMID: 26707790 DOI: 10.1111/jon.12325] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Revised: 11/25/2015] [Accepted: 11/26/2015] [Indexed: 01/31/2023] Open
Abstract
BACKGROUND AND PURPOSE To determine the feasibility of apparent diffusion coefficient (ADC)-based thermometry to assess intraventricular temperature in children. METHODS ADC maps were generated from diffusion tensor imaging data, which were acquired with diffusion gradients along 20 noncollinear directions using a b-value of 1000 s/mm(2) . The intraventricular temperature was calculated based on intraventricular ADC values and the mode method as previously reported. The calculated intraventricular temperature was validated with an estimated brain temperature based on temporal artery temperature measurements. We included 120 children in this study (49 females, 71 males, mean age 6.63 years), 15 consecutive children for each of the following age groups: 0-1, 1-2, 2-4, 4-6, 6-8, 8-10, 10-14, and 14-18 years. Forty-three children had a normal brain MRI and 77 children had an abnormal brain scan. Polynomial fitting to the temperature distribution and subsequent calculation of mode values was performed. A correlation coefficient and a coefficient of determination were calculated between ADC calculated temperatures and estimated brain temperatures. Linear regression analysis was performed to investigate the two temperature measures. RESULTS ADC-based intraventricular temperatures ranged between 31.5 and 39.6 °C, although estimated brain temperatures ranged between 36.3 and 38.1 °C. The difference between the temperatures is larger for children with more than 8,000 voxels within the lateral ventricles compared to children with less than 8,000 voxels. The correlation coefficient between ADC-based temperatures and the estimated brain temperatures is .1, the respective R(2) is .01 indicating that 1% of the changes in estimated brain temperatures are attributable to corresponding changes in ADC-based temperature measurements (P = .275). CONCLUSIONS ADC-based thermometry has limited application in the pediatric population mainly due to a small ventricular size.
Collapse
Affiliation(s)
- Matthias W Wagner
- Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD.,Department of Diagnostic and Interventional Radiology, University Hospital Zurich, Zurich, Switzerland
| | - Steven E Stern
- School of Mathematical Sciences, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Alexander Oshmyansky
- Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD.,School of Mathematical Sciences, Faculty of Science and Engineering, Queensland University of Technology, Brisbane, QLD, Australia
| | - Thierry A G M Huisman
- Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
| | - Andrea Poretti
- Section of Pediatric Neuroradiology, Division of Pediatric Radiology, Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, Baltimore, MD
| |
Collapse
|
20
|
Babourina-Brooks B, Simpson R, Arvanitis TN, Machin G, Peet AC, Davies NP. MRS thermometry calibration at 3 T: effects of protein, ionic concentration and magnetic field strength. NMR IN BIOMEDICINE 2015; 28:792-800. [PMID: 25943246 DOI: 10.1002/nbm.3303] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/14/2014] [Revised: 03/12/2015] [Accepted: 03/13/2015] [Indexed: 06/04/2023]
Abstract
MRS thermometry has been utilized to measure temperature changes in the brain, which may aid in the diagnosis of brain trauma and tumours. However, the temperature calibration of the technique has been shown to be sensitive to non-temperature-based factors, which may provide unique information on the tissue microenvironment if the mechanisms can be further understood. The focus of this study was to investigate the effects of varied protein content on the calibration of MRS thermometry at 3 T, which has not been thoroughly explored in the literature. The effects of ionic concentration and magnetic field strength were also considered. Temperature reference materials were controlled by water circulation and freezing organic fixed-point compounds (diphenyl ether and ethylene carbonate) stable to within 0.2 °C. The temperature was measured throughout the scan time with a fluoro-optic probe, with an uncertainty of 0.16 °C. The probe was calibrated at the National Physical Laboratory (NPL) with traceability to the International Temperature Scale 1990 (ITS-90). MRS thermometry measures were based on single-voxel spectroscopy chemical shift differences between water and N-acetylaspartate (NAA), Δ(H20-NAA), using a Philips Achieva 3 T scanner. Six different phantom solutions with varying protein or ionic concentration, simulating potential tissue differences, were investigated within a temperature range of 21-42 °C. Results were compared with a similar study performed at 1.5 T to observe the effect of field strengths. Temperature calibration curves were plotted to convert Δ(H20-NAA) to apparent temperature. The apparent temperature changed by -0.2 °C/% of bovine serum albumin (BSA) and a trend of 0.5 °C/50 mM ionic concentration was observed. Differences in the calibration coefficients for the 10% BSA solution were seen in this study at 3 T compared with a study at 1.5 T. MRS thermometry may be utilized to measure temperature and the tissue microenvironment, which could provide unique unexplored information for brain abnormalities and other pathologies.
Collapse
Affiliation(s)
- Ben Babourina-Brooks
- School of Cancer Sciences, University of Birmingham, Birmingham, West Midlands, UK
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, West Midlands, UK
| | - Robert Simpson
- Temperature Group, National Physical Laboratory, Teddington, Middlesex, UK
| | - Theodoros N Arvanitis
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, West Midlands, UK
- Institute of Digital Healthcare, WMG, University of Warwick, Coventry, UK
| | - Graham Machin
- Temperature Group, National Physical Laboratory, Teddington, Middlesex, UK
| | - Andrew C Peet
- School of Cancer Sciences, University of Birmingham, Birmingham, West Midlands, UK
- Birmingham Children's Hospital NHS Foundation Trust, Birmingham, West Midlands, UK
| | - Nigel P Davies
- School of Cancer Sciences, University of Birmingham, Birmingham, West Midlands, UK
- Imaging and Medical Physics, University Hospitals Birmingham NHS Foundation Trust, Birmingham, West Midlands, UK
| |
Collapse
|
21
|
Atallah L, Bongers E, Lamichhane B, Bambang-Oetomo S. Unobtrusive Monitoring of Neonatal Brain Temperature Using a Zero-Heat-Flux Sensor Matrix. IEEE J Biomed Health Inform 2014; 20:100-7. [PMID: 25546867 DOI: 10.1109/jbhi.2014.2385103] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The temperature of preterm neonates must be maintained within a narrow window to ensure their survival. Continuously measuring their core temperature provides an optimal means of monitoring their thermoregulation and their response to environmental changes. However, existing methods of measuring core temperature can be very obtrusive, such as rectal probes, or inaccurate/lagging, such as skin temperature sensors and spot-checks using tympanic temperature sensors. This study investigates an unobtrusive method of measuring brain temperature continuously using an embedded zero-heat-flux (ZHF) sensor matrix placed under the head of the neonate. The measured temperature profile is used to segment areas of motion and incorrect positioning, where the neonate's head is not above the sensors. We compare our measurements during low motion/stable periods to esophageal temperatures for 12 preterm neonates, measured for an average of 5 h per neonate. The method we propose shows good correlation with the reference temperature for most of the neonates. The unobtrusive embedding of the matrix in the neonate's environment poses no harm or disturbance to the care work-flow, while measuring core temperature. To address the effect of motion on the ZHF measurements in the current embodiment, we recommend a more ergonomic embedding ensuring the sensors are continuously placed under the neonate's head.
Collapse
|
22
|
Wu TW, McLean C, Friedlich P, Wisnowski J, Grimm J, Panigrahy A, Bluml S, Seri I. Brain temperature in neonates with hypoxic-ischemic encephalopathy during therapeutic hypothermia. J Pediatr 2014; 165:1129-34. [PMID: 25151196 DOI: 10.1016/j.jpeds.2014.07.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 06/02/2014] [Accepted: 07/08/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To noninvasively determine brain temperature of neonates with hypoxic-ischemic encephalopathy (HIE) during and after therapeutic hypothermia. STUDY DESIGN Using a phantom, we derived a calibration curve to calculate brain temperature based on chemical shift differences in magnetic resonance spectroscopy. We enrolled infants admitted for therapeutic hypothermia and assigned them to a moderate HIE (M-HIE) or severe HIE (S-HIE) group based on Sarnat staging. Rectal (core) temperature and magnetic resonance spectroscopy data used to derive regional brain temperatures (basal ganglia, thalamus, and cortical gray matter) were acquired concomitantly during and after therapeutic hypothermia. We compared brain and rectal temperature in the M-HIE and S-HIE groups during and after therapeutic hypothermia using 2-tailed t-tests. RESULTS Eighteen patients (14 with M-HIE and 4 with S-HIE) were enrolled. As expected, both brain and rectal temperatures were lower during therapeutic hypothermia than after therapeutic hypothermia. Brain temperature in patients with S-HIE was higher than in those with M-HIE both during (35.1 ± 1.3°C vs 33.7 ± 1.2°C; P < .01) and after therapeutic hypothermia (38.1 ± 1.5°C vs 36.8 ± 1.3°C; P < .01). The brain-rectal temperature gradient was also greater in the S-HIE group both during and after therapeutic hypothermia. CONCLUSION For this analysis of a small number of patients, brain temperature and brain-rectal temperature gradient were higher in neonates with S-HIE than in those with M-HIE during and after therapeutic hypothermia. Further studies are needed to determine whether further decreasing brain temperature in neonates with S-HIE is safe and effective in improving outcome.
Collapse
Affiliation(s)
- Tai-Wei Wu
- Division of Neonatal Medicine, Department of Pediatrics, Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA.
| | - Claire McLean
- Division of Neonatal Medicine, Department of Pediatrics, Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Philippe Friedlich
- Division of Neonatal Medicine, Department of Pediatrics, Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jessica Wisnowski
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - John Grimm
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Ashok Panigrahy
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Stefan Bluml
- Department of Radiology, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Istvan Seri
- Division of Neonatal Medicine, Department of Pediatrics, Center for Fetal and Neonatal Medicine, Children's Hospital Los Angeles, Keck School of Medicine, University of Southern California, Los Angeles, CA
| |
Collapse
|
23
|
Babourina-Brooks B, Wilson M, Arvanitis TN, Peet AC, Davies NP. MRS water resonance frequency in childhood brain tumours: a novel potential biomarker of temperature and tumour environment. NMR IN BIOMEDICINE 2014; 27:1222-9. [PMID: 25125325 PMCID: PMC4491353 DOI: 10.1002/nbm.3177] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2013] [Revised: 06/13/2014] [Accepted: 07/10/2014] [Indexed: 06/03/2023]
Abstract
(1)H MRS thermometry has been investigated for brain trauma and hypothermia monitoring applications but has not been explored in brain tumours. The proton resonance frequency (PRF) of water is dependent on temperature but is also influenced by microenvironment factors, such as fast proton exchange with macromolecules, ionic concentration and magnetic susceptibility. (1)H MRS has been utilized for brain tumour diagnostic and prognostic purposes in children; however, the water PRF measure may provide complementary information to further improve characterization. Water PRF values were investigated from a repository of MRS data acquired from childhood brain tumours and children with apparently normal brains. The cohort consisted of histologically proven glioma (22), medulloblastoma (19) and control groups (28, MRS in both the basal ganglia and parietal white matter regions). All data were acquired at 1.5 T using a short TE (30 ms) single voxel spectroscopy (PRESS) protocol. Water PRF values were calculated using methyl creatine and total choline. Spectral peak amplitude weighted averaging was used to improve the accuracy of the measurements. Mean PRF values were significantly larger for medulloblastoma compared with glioma, with a difference in the means of 0.0147 ppm (p < 0.05), while the mean PRF for glioma was significantly lower than for the healthy cohort, with a difference in the means of 0.0061 ppm (p < 0.05). This would suggest the apparent temperature of the glioma group was ~1.5 °C higher than the medulloblastomas and ~0.7 °C higher than a healthy brain. However, the PRF shift may not reflect a change in temperature, given that alterations in protein content, microstructure and ionic concentration contribute to PRF shifts. Measurement of these effects could also be used as a supplementary biomarker, and further investigation is required. This study has shown that the water PRF value has the potential to be used for characterizing childhood brain tumours, which has not been reported previously.
Collapse
Affiliation(s)
- Ben Babourina-Brooks
- School of Cancer Sciences, University of BirminghamBirmingham, West Midlands, UK
- Children's Hospital NHS Foundation TrustBirmingham, West Midlands, UK
| | - Martin Wilson
- School of Cancer Sciences, University of BirminghamBirmingham, West Midlands, UK
- Children's Hospital NHS Foundation TrustBirmingham, West Midlands, UK
| | - Theodoros N Arvanitis
- Children's Hospital NHS Foundation TrustBirmingham, West Midlands, UK
- Institute of Digital Healthcare, WMG, University of WarwickCoventry, UK
| | - Andrew C Peet
- School of Cancer Sciences, University of BirminghamBirmingham, West Midlands, UK
- Children's Hospital NHS Foundation TrustBirmingham, West Midlands, UK
| | - Nigel P Davies
- School of Cancer Sciences, University of BirminghamBirmingham, West Midlands, UK
- Imaging and Medical Physics, University Hospitals Birmingham NHS Foundation TrustBirmingham, West Midlands, UK
| |
Collapse
|
24
|
Bainbridge A, Kendall GS, De Vita E, Hagmann C, Kapetanakis A, Cady EB, Robertson NJ. Regional neonatal brain absolute thermometry by 1H MRS. NMR IN BIOMEDICINE 2013; 26:416-423. [PMID: 23074155 DOI: 10.1002/nbm.2879] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2012] [Revised: 08/28/2012] [Accepted: 09/04/2012] [Indexed: 06/01/2023]
Abstract
Therapeutic hypothermia is standard care for infants with moderate to severe encephalopathy. (1) H MRS thermometry (MRSt) measures regional brain absolute temperature using the temperature-dependent water chemical shift. This study evaluates the clinical feasibility of MRSt in human neonates, and correlates white matter (WM) and thalamus (Thal) MRSt with conventional rectal temperature (Trectal ) measurement. Fifty-six infants born at term underwent perinatal MRSt for suspected hypoxic-ischaemic brain injury and 33 infants born preterm had MRSt at a term-equivalent age; 56 of the 89 had Trectal measured after MRSt of either a Thal or posterior WM voxel, or both. MRSt used point-resolved spectroscopy (no water suppression; TR = 1370 ms; TE = 288 ms; 1.5 × 1.5 × 1.5 cm(3) Thal and 1.1 × 1.3 × 1.4 cm(3) WM voxels). Time domain data were phase and frequency corrected before summation and motion-corrupted data were excluded from further analysis using simple criteria [preprocessing + quality assurance (QA)]. Two published water temperature-dependence calibrations [both using cerebral creatine (Cr), choline (Cho) and N-acetylaspartate (Naa) as independent reference peaks] were compared. The temperature measurements derived from Cr, Cho and Naa were combined to give a single amplitude-weighted combination temperature (TAWC ). WM and Thal TAWC correlated linearly with Trectal (Thal slope, 0.82 ± 0.04, R(2) = 0.85, p < 0.05; WM slope, 0.95 ± 0.04, R(2) = 0.78, p < 0.05). Preprocessing + QA improved the correlation between WM TAWC and Trectal (R(2) increased from 0.27 to 0.78, p < 0.001). Both calibration datasets showed specific inconsistencies between the temperatures calculated using Cr, Cho and Naa reference peaks when applied to this neonatal dataset. Neonatal MRSt is clinically feasible. Preprocessing + QA improved MRSt reliability in WM. The consideration of MRSt calibration internal biases is necessary before combining MRSt temperatures from multiple reference peaks to obtain TAWC.
Collapse
Affiliation(s)
- Alan Bainbridge
- Medical Physics and Bioengineering, University College London Hospitals NHS Foundation Trust, London, UK
| | | | | | | | | | | | | |
Collapse
|
25
|
Differential temporal evolution patterns in brain temperature in different ischemic tissues in a monkey model of middle cerebral artery occlusion. J Biomed Biotechnol 2012; 2012:980961. [PMID: 23091367 PMCID: PMC3468286 DOI: 10.1155/2012/980961] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Accepted: 08/31/2012] [Indexed: 11/21/2022] Open
Abstract
Brain temperature is elevated in acute ischemic stroke, especially in the ischemic penumbra (IP). We attempted to investigate the dynamic evolution of brain temperature in different ischemic regions in a monkey model of middle cerebral artery occlusion. The brain temperature of different ischemic regions was measured with proton magnetic resonance spectroscopy (1H MRS), and the evolution processes of brain temperature were compared among different ischemic regions. We found that the normal (baseline) brain temperature of the monkey brain was 37.16°C. In the artery occlusion stage, the mean brain temperature of ischemic tissue was 1.16°C higher than the baseline; however, this increase was region dependent, with 1.72°C in the IP, 1.08°C in the infarct core, and 0.62°C in the oligemic region. After recanalization, the brain temperature of the infarct core showed a pattern of an initial decrease accompanied by a subsequent increase. However, the brain temperature of the IP and oligemic region showed a monotonously and slowly decreased pattern. Our study suggests that in vivo measurement of brain temperature could help to identify whether ischemic tissue survives.
Collapse
|
26
|
Central hyperthermia, brain hyperthermia and low hypothalamus temperature. Clin Auton Res 2012; 22:299-301. [PMID: 22875550 DOI: 10.1007/s10286-012-0174-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2012] [Accepted: 07/09/2012] [Indexed: 01/27/2023]
Abstract
UNLABELLED INTRODUCTION, PATIENTS AND METHODS: We measured brain temperature in a case of central hyperthermia. RESULTS Brain temperature was increased except for hypothalamus that was colder. CONCLUSION We suppose that central hyperthermia is driven by cold hypothalamus.
Collapse
|